| NPI | 1730827023 |
|---|---|
| Other Name | FAMILY LEGACY THERAPY PROFESSIONAL CORPORATION |
| Entity Type | Organization |
| Authorized Contact | SAN JUANA MELGOZA CEO 209-298-0510 |
| Organization Subpart ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist |
| Enumeration Date | 2022-05-25 |
| Last Update Date | 2022-05-25 |